A nurse is preparing to give an SBAR report to a healthcare provider about a postoperative patient who is showing signs of respiratory distress and unstable vital signs. Which of the following actions should the nurse take when using the SBAR technique? (Select all that apply)

Rationale:
A. Ensuring all staff use encrypted login credentials and automatic logoff features is correct because the HITECH Act strengthened HIPAA by emphasizing the protection of electronic protected health information (ePHI). Encryption prevents unauthorized access, and automatic logoff reduces the risk of accidental exposure of sensitive data. These measures are fundamental for compliance with HIPAA’s privacy and security rules and help safeguard patient information in electronic systems.

B. Disabling audit trails is incorrect because audit trails are a critical component of security monitoring and accountability. They allow organizations to track access to ePHI and detect potential breaches, which is a key enhancement emphasized under the HITECH Act. Disabling them would violate privacy and security requirements.

C. Sharing client PHI through unencrypted email is incorrect because it exposes sensitive information to potential interception. HITECH specifically requires that electronic communication containing PHI be secure and encrypted to prevent unauthorized access.

D. Allowing staff to use personal mobile devices freely is incorrect because unrestricted use of personal devices increases the risk of data breaches, loss, or theft of ePHI. The HITECH Act encourages strict policies for mobile device access, including encryption, password protection, and organizational oversight.

Rationale:
A. Obtaining verbal consent without a signed document is incorrect because for elective surgeries, a signed informed consent form is legally required. Verbal consent alone does not meet legal or institutional standards and cannot replace the formal documentation process.

B. Verifying that the patient understands the procedure and its risks is correct because the nurse’s role in witnessing consent includes confirming that the patient has received appropriate information from the provider and comprehends the nature, purpose, risks, and benefits of the procedure. This ensures informed decision-making.

C. Providing detailed postoperative care plans during the consent process is incorrect because the nurse should not provide medical advice or substitute for the provider’s explanation. Postoperative instructions are important but are part of patient education, not the consent process itself.

D. Explaining alternative treatment options that the provider did not discuss is incorrect because the nurse does not provide or interpret treatment options. Discussing alternatives is the responsibility of the provider obtaining consent. The nurse can clarify what was explained but cannot add new medical information.

E. Witnessing the patient’s signature on the consent form after confirming understanding is correct because the nurse ensures the signature is authentic and that the patient is voluntarily consenting. This action does not involve providing medical explanations but confirms legal and ethical standards are met.

F. Confirming the patient is legally competent and not under the influence of sedatives is correct because a patient must be able to make an informed decision. The nurse verifies that the patient has the cognitive ability and capacity to provide voluntary consent, which protects both the patient and the institution legally.